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Insurance Utilization Review Jobs in Utah (NOW HIRING)

University of Utah Health

Case Manager

Salt Lake City, UT · On-site

$19.25 - $25/hr

Assesses and discusses funding and insurance issues with client, family, and healthcare providers ... Negotiates with third party payers relative to benefit levels, eligibility, utilization review, and ...

University of Utah Health

Case Manager

Salt Lake City, UT · On-site

$19.25 - $25/hr

Assesses and discusses funding and insurance issues with client, family, and healthcare providers ... Negotiates with third party payers relative to benefit levels, eligibility, utilization review, and ...

University of Utah Health

Case Manager

Salt Lake City, UT · On-site

$19.75 - $25.25/hr

Assesses and discusses funding and insurance issues with client, family, and healthcare providers ... Negotiates with third party payers relative to benefit levels, eligibility, utilization review, and ...

University of Utah Health

Case Manager

Salt Lake City, UT · On-site

$19.25 - $25/hr

Assesses and discusses funding and insurance issues with client, family, and healthcare providers ... Negotiates with third party payers relative to benefit levels, eligibility, utilization review, and ...

University of Utah Health

Case Manager

Salt Lake City, UT · On-site

$19.75 - $25.50/hr

Assesses and discusses funding and insurance issues with client, family, and healthcare providers ... Negotiates with third party payers relative to benefit levels, eligibility, utilization review, and ...

Amazon

Staff Pharmacist, Amazon Pharmacy

Salt Lake City, UT · On-site

$57.50 - $67.75/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

... DUR (Drug Utilization Review) and ensure accurate documentation in pharmacy systems • Monitor ... Amazon also offers comprehensive benefits including health insurance (medical, dental, vision ...

Mountain View Hospital

Social Worker

Payson, UT · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Performs utilization review as assigned. * Helps with Process and Quality Improvement initiatives ... Additional benefits for fertility and family building, adoption assistance, life insurance ...

HOME CAREGIVERS PARTNERSHIP LLC

RN

Salt Lake City, UT

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Health, dental, vision, and life insurance. 401(k) savings plan. PTO. Responsibilities: - Utilizes ... Participates in utilization review of medical records as assigned. * Gives total patient care as ...

HOME CAREGIVERS PARTNERSHIP LLC

RN

Springville, UT

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Health, dental, vision, and life insurance. 401(k) savings plan. PTO. Responsibilities: - Utilizes ... Participates in utilization review of medical records as assigned. * Gives total patient care as ...

HOME CAREGIVERS PARTNERSHIP LLC

RN

South Ogden, UT

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Health, dental, vision, and life insurance. 401(k) savings plan. PTO. Responsibilities: - Utilizes ... Participates in utilization review of medical records as assigned. * Gives total patient care as ...

HOME CAREGIVERS PARTNERSHIP LLC

RN

Salt Lake City, UT · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Health, dental, vision, and life insurance. 401(k) savings plan. PTO. Responsibilities: - Utilizes ... Participates in utilization review of medical records as assigned. * Gives total patient care as ...

HOME CAREGIVERS PARTNERSHIP LLC

RN

Springville, UT

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Health, dental, vision, and life insurance. 401(k) savings plan. PTO. Responsibilities: - Utilizes ... Participates in utilization review of medical records as assigned. * Gives total patient care as ...

HOME CAREGIVERS PARTNERSHIP LLC

RN

South Ogden, UT · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Health, dental, vision, and life insurance. 401(k) savings plan. PTO. Responsibilities: - Utilizes ... Participates in utilization review of medical records as assigned. * Gives total patient care as ...

Lewis-Gale Medical Center

RN Case Manager

Ogden, UT · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Orientation will also include Medicare and insurance benefits, grievance procedures, treatment plan ... Certification in case management or utilization review preferred. * InterQual experience preferred.

New

Medical City Healthcare

RN Case Manager

Ogden, UT · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Orientation will also include Medicare and insurance benefits, grievance procedures, treatment plan ... Certification in case management or utilization review preferred. * InterQual experience preferred.

New

Mission Hospital

RN Case Manager

South Weber, UT · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Orientation will also include Medicare and insurance benefits, grievance procedures, treatment plan ... Certification in case management or utilization review preferred. * InterQual experience preferred.

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All JobsInsurance Utilization Review JobsInsurance Utilization Review Jobs in Utah

Insurance Utilization Review information

See Utah salary details

$19

$38

$62

How much do insurance utilization review jobs pay per hour?

As of Aug 14, 2026, the average hourly pay for insurance utilization review in Utah is $38.49, according to ZipRecruiter salary data. Most workers in this role earn between $30.43 and $44.18 per hour, depending on experience, location, and employer.

What are the most common challenges faced by insurance utilization review professionals?

One common challenge in Insurance Utilization Review is balancing the need for cost-effective care with the clinical needs of patients, which often requires careful analysis and decision-making. Professionals in this role frequently navigate complex medical records, strict policy guidelines, and collaborate with healthcare providers who may advocate strongly for particular treatments. Managing challenging conversations while maintaining professionalism and ensuring timely determinations are also a regular part of the role. Developing expertise in these areas can make the job both demanding and rewarding, while building a strong foundation for career growth within healthcare administration.

What are the key skills and qualifications needed to thrive in insurance utilization review?

To thrive in Insurance Utilization Review, you generally need a strong background in healthcare or nursing, an understanding of medical terminology, and analytical thinking skills, often supported by an RN license or relevant clinical experience. Familiarity with utilization management software, coding systems like ICD-10, and knowledge of regulatory requirements (such as Medicare or Medicaid) are important. Strong communication, attention to detail, and problem-solving abilities help professionals excel when interacting with providers and insurers. These skills are essential to ensure appropriate care is authorized while maintaining regulatory compliance and cost-effectiveness.

What is an insurance utilization review?

An Insurance Utilization Review job involves evaluating medical treatments and services to determine if they are necessary, appropriate, and covered by a patient's insurance plan. Professionals in this role review medical records, treatment plans, and insurance policies to ensure compliance with guidelines and cost-effectiveness. They work closely with healthcare providers, insurance companies, and patients to facilitate approvals or appeals. The goal is to balance quality patient care with cost containment in the healthcare system.

What are the most commonly searched types of Insurance Utilization Review jobs in Utah?

The most popular types of Insurance Utilization Review jobs in Utah are:

What are popular job titles related to Insurance Utilization Review jobs in Utah?

For Insurance Utilization Review jobs in Utah, the most frequently searched job titles are:

What job categories do people searching Insurance Utilization Review jobs in Utah look for?

The top searched job categories for Insurance Utilization Review jobs in Utah are:

Insurance Utilization Review jobs near you
Infographic showing various Insurance Utilization Review job openings in Utah as of August 2026, with employment types broken down into 1% As Needed, 58% Full Time, 27% Part Time, and 14% Contract. Highlights an 91% Physical, 1% Hybrid, and 8% Remote job distribution, with an average salary of $80,064 per year, or $38.5 per hour.

Case Manager

University of Utah Health

Salt Lake City, UT • On-site

$19.25 - $25/hr

Full-time

Re-posted 19 days ago

University Of Utah Health rating

7.7

Company rating: 7.7 out of 10

Based on 142 frontline employees who took The Breakroom Quiz

157th of 887 rated healthcare providers

Job description

Overview
As a patient-focused organization, University of Utah Health exists to enhance the health and well-being of people through patient care, research and education. Success in this mission requires a culture of collaboration, excellence, leadership, and respect. University of Utah Health seeks staff that are committed to the values of compassion, collaboration, innovation, responsibility, integrity, quality and trust that are integral to our mission. EO/AA
This position provides clinical case management services aimed at enhancing patient-centered care and maximizing outcomes across the patient care continuum from pre-admission through post-discharge. Case management services include monitoring patient care to ensure progress toward desired outcome, addressing patient and family needs, resolving obstacles to effective care, coordinating care with payers and vendors, patients and families. Together with the multiple other internal team member the case manager is responsible for establishing, monitoring and executing patients discharge plan. This position may be required to access and administer medications within their scope of practice and according to State Law.
Corporate Overview: The University of Utah is a Level 1 Trauma Center and is nationally ranked and recognized for our academic research, quality standards and overall patient experience. Our five hospitals and eleven clinics provide excellence in our comprehensive services, medical advancement, and overall patient outcomes.
Responsibilities
  • Coordinates case management process from patient's entry into the healthcare system to post-discharge, including outpatient settings. Coordinates care and resources with physicians, social workers, and other team members to achieve optimal patient outcomes.
  • Identifies patients who are suitable for case management intervention based on criteria such as cost, case complexity, frequency of admission or patient/family/provider or other healthcare team member request.
  • Monitors and documents quality of care to ensure patient care plan goals are appropriate and that they are understood and implemented. Routinely assesses client and family response to services, while also measuring care plan effectiveness and necessity. Identifies patient needs, including those of an ethical and cultural nature, and ensures they are addressed.
  • Facilitates cost effective outcomes by determining appropriate level of care based on diagnosis, severity, intensity of services required, and other relevant criteria, using national and regional length of stay standards and community norms.
  • Assesses and discusses funding and insurance issues with client, family, and healthcare providers to enhance cost effective utilization of services and quality outcomes.
  • Negotiates with third party payers relative to benefit levels, eligibility, utilization review, and reimbursement.
  • Identifies actual and potential delays in service requests or treatment and communicates them to health care team so steps can be taken to eliminate or minimize delays.
  • Works with other team members to plan appropriate and timely discharges.
  • Establishes measurable discharge planning and self-management goals that promote safe, cost effective, high quality outcomes.
  • Provides oversight of issuance of CMS Important Message to patients.
  • Supervises technical support staff assigned to individual case management teams.
  • May set up patients' follow up appointments and performs post discharge phone calls to patients per care team design.
  • May be required to complete home or site visits as required by the department.
  • At the discretion of department operational and patient care needs, this position is required to work rotating schedules, which may include variable hours, weekends, nights, and holidays to meet the staffing and patient care demands of a 24/7 complex health system. Regular, reliable, and punctual attendance during assigned shifts is considered an essential function of the role.
Knowledge / Skills / Abilities
  • Ability to perform the essential functions of the job as outlined above.
  • Demonstrated availability to work variable and rotating shifts, including nights, weekends, and holidays, in a 24/7 patient care environment.
  • Demonstrated team leadership, relationship building, critical analysis, and written and verbal communication skills.
  • Knowledge of funding resources and clinical standards and outcomes.
  • Ability to provide care appropriate to the population served.
  • Demonstrated independent judgment to assess and meet client needs. Ability to have meaningful outcome oriented dialogues with patients, families, various patient care disciplines, ancillary departments, health care and community agencies, third party payors, and Health Science Center professional schools in coordinating care and services for patients.
  • The staff member must be able to demonstrate the knowledge and skills necessary to provide care appropriate to the age of the patients served on his or her assigned area.
  • The individual must demonstrate knowledge of the principles of life span growth and development and the ability to assess data regarding the patient's status and provide care as described in the department's policies and procedures manual.

Qualifications
Qualifications
Required
  • Two years of professional experience in a clinically related area.
  • Dependent upon the department of hire, may be required to provide reliable transportation for site visits.
Licenses Required
  • One of the following
    • Current license to practice as a Registered Nurse in the State of Utah, or obtain one within 90 days of hire under the interstate compact if switching residency to State of Utah. Must maintain current Interstate Compact (multi-state) license if residency is not being changed to Utah.
    • Current Licensed Clinical Social Worker (L.C.S.W.) certificate for clinical practice in the State of Utah.
    • Current license to practice as a Clinical Mental Health Counselor in the State of Utah.
    • Current license to practice as a Physical Therapist in the State of Utah, or obtain one within 90 days of hire under the Physical Therapy Compact if switching residency to State of Utah. Must maintain current Physical Therapy Compact (multi-state) license if residency is not being changed to Utah.
    • Current licensure to practice as an Occupational Therapist in the State of Utah.
* Additional license requirements as determined by the hiring department.
Qualifications (Preferred)
Preferred
  • Basic Life Support Health Care Provider card through American Heart Association.
  • A Certified Case Management designation.
  • Previous experience in clinical resource management activities and third party payer interactions.
Working Conditions and Physical Demands
Employee must be able to meet the following requirements with or without an accommodation.
  • This position involves light work that may exert up to 20 pounds and may consistently require light work involving lifting, carrying, pushing, pulling or otherwise moving objects involving patient care or medical equipment. This position does not provide any direct patient care. Workers in this position may be exposed to infectious diseases and may be required to function around prisoners or behavioral health patients.

Physical Requirements
Carrying, Climbing, Color Determination, Far Vision, Lifting, Listening, Manual Dexterity, Near Vision, Non Indicated, Pulling and/or Pushing, Reaching, Sitting, Speaking, Standing, Stooping and Crouching, Walking

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